Objective:To optimize the ethanol reflux extraction process for Aitong cataplasm .Methods: Orthogonal design was used to investigate the effect of solid-liquid ratio,extraction time and times on the extraction technology of Aitong cataplasm with the content of asarinin and dry extract yield as the indices .Results:The best extraction conditions were as follows:extracted 3 times with 8-fold amount of 70%ethanol, and 1 hour for each time.Conclusion: The optimized extraction process is stable and feasible , which can be used to extract Aitong cataplasm .

Objective:To study the influence of “Warming Yang and Nourishing Qi”Acupuncture in the expression levels of acetylcholine receptor protein (AchR)in gastrocnemius neuromuscular junction (NMJ)of the rats with experimental autoimmune myasthenia gravis (EAMG),and to clarify the mechanism of “Warming Yang and Nourishing Qi”Acupucture in the treatment myasthenia gravis (MG).Methods:The female Lewis rats were used to establish the EAMG rat models immuned with AchRα1 129-145 polypeptide fragments.30 EAMG rats were selected randomly and divided into model control group, drug control group, and acupuncture treatment group (n=10),and another 10 rats purchased at the same period were used as blank control group.The rats in drug control group were treated with 1 8.5 mg · kg-1 · d-1 pyridostigmine by gavage. And the rats in acupuncture treatment group were treated with irritating by“Warming Yang and Nourishing Qi”Acupuncture.The rats in blank control group and model control group were not treated .The Lennon symptom scores of the rats in various groups were recorded.After treatment,the tissues of gastrocnemius NMJ of the rats were taken,and the AchR protein expression levels in NMJ of the rats in various groups were detected by Western blotting method. Results:Compared with blank control group,after successfully modelling,the Lennon symptom scores of the rats in model control group, drug control group and acupuncture treatment group before treatment were significantly increased (P<0.01).Compared with model control group,the Lennon symptom scores of the rats in drug control group and acupuncture treatment group after two treatment course were significantly increased (P<0.01 ). Compared with blank control group, the AchR protein expression level in gastronemus NMJ of the rats in model control group was significantly decreased (P<0.01). Compared with model control group, the AchR protein expression levels in gastronemus NMJ of the rats in acupuncture treatment group and drug control group after treatment were significantly increased (P<0.01).Conclusion:“Warming Yang and Nourishing Qi”Acupuncture has good therapeutic effect on the EAMG through increasing the NMJ AchR protein expression level of the EAMG rats.

Objective:To observe the effect of “Warming Yang and Nourishing Qi” Acupuncture on the acetylcholine receptor (AchR)mRNA expression in neuromuscular junction (NMJ)of the rats with experimental autoimmune myasthenis gravis (EAMG), and to analyze the mechanism of acupuncture treatment for EAMG. Methods:AchRα1 129-145 peptide fragments were used to immune the 60 female Lewis rats to establish the EAMG rat models. 30 EAMG rats were selected randomly and divided into model control group,acupuncture treatment group and drug control group (n = 10).Another 10 SPF- “grade three”female Lewis rats,which were raised together with EAMG rats,were used as blank control group. The rats in model control group and blank control group had no treatment.The rats in acupuncture treatment group were treated with “Warming Yang and Nourishing Qi”Acupuncture.The rats in drug control group were treated with pyridostigmine bromide by gavage. The tissue samples in NMJ of gastrocnemius of the rats were collected,and the expression levels of AChR mRNA were detected with Real-time PCR method; the differences among various groups were analyzed quantitatively. Results:Compared with blank control group,the expression levels ofγ-AChR mRNA andε-AChR mRNA in NMJ of the rats in acupuncture treatment group drug control group and model control group were significantly increased (P <0.01).Compared with model control group,theγ-AChR mRNA andε-AChR mRNA in NMJ of the rats in drug acupuncture treatment group and control group were significantly increased (P < 0.01 ). Conclusion:“Warming Yang and Nourishing Qi”Acupuncture can effectively improve the expression level of AchR mRNA and it is an effective treatment method for myasthenia gravis.

Objective To investigate the appropriate low tube current of abdominal CT on a 64-slice spiral CT. Methods (1) Phantom study:The phantom Catphan500R was scanned with a fixed 120 kVp,and 450,400,380,360,340,320,300,280 mA, respectively. 15, 9, 8, 7, 6 mm diameter low-contrast objects with 1% contrast were scanned for evaluating image quality. CT images were graded in terms of lowcontrast conspicuity by using a five-point scale. Statistical analyses were performed to determine the appropriate tube current and the interval leading to the qualitative change. (2) Clinical study: 3 groups of 45 patients who had 2 examinations of non-enhanced abdominal CT within 3 months were enrolled. All patients were scanned with 450 mA at first scanning. For the second scanning, group-1 was scanned with optimal tube current, group-2 was scanned with optimal tube current plus interval, group-3 was scanned with optimal tube current sinus interval. CT images were graded in terms of the diagnostic acceptability at three anatomic levels including porta hepatis, pancreas and the upper pole kidney, and the image noises of eight organs including abdominal aorta, portal vein, liver, spleen, gallbladder, pancreas, renal cortex, renal medulla were graded by using a five-point scale. The image quality was compared with non-parametric rank sum test,and the individual factors of the patients were compared with the A VONA. Results (1) The optimal tube current and interval leading to the qualitative change were 340 mA and 40 mA respectively. (2) There were no significant differences in image quality between 340 mA and 450 mA in group-1, between 380 mA and 450 mA in group-2 (P ＞ 0. 05). There was significant difference in image quality between 300 mA and 450 mA in group-3 (the mean scores for 300 mA were 2. 92 ± 0. 62,2.92 ± 0. 62,2.64 ± 0. 84,2. 72 ±0.82,2.63 ±0.71,2.51 ±0.84,3.04 ±0.72,3.04 ±0.72,2.63 ±0.71,2.52 ±0.73,2.93 ±0.81respectively; for 450 mA were 3.93 ± 0. 72,3.94 ± 0. 72,3.41 ± 0. 64,3.43 ± 0. 61,3.62 ± 0. 93,3.63 ±0.71,3.93 ±0.81,3.93 ±0.81,3.43 ±0.61,3.52 ±0.92,3.84 ±0.82 respectively) (Z = -2.449 to - 2. 236, P ＜ 0. 05). Conclusion Radiation dose can be effectively reduced by using an appropriate and lower current of 340 mA.

Objective To explore the effect of amisulpride and risperidone in the treatment of patients with first-episode schizophrenia and its influence on social function.Methods 70 patients of schizophrenia conformed to the International classification of diseases tenth edition(ICD-10) were randomly divided into amisulpride group(observation group,35 cases) and risperidone group(control group,35 cases) by using the random number table method.The Positive and Negative Scale(PANSS) was used to evaluate the efficacy,the Scale of Social Function in Psychosis Inpatients(SSPI) was used to evaluate social function before and after 8 weeks of treatment.Results After 8 weeks treatment,the negative symptom factor score of the PANSS in the observation group was (15.04±3.55)points,which was improved significantly compared with (17.82±3.87)points in the control group,the difference was statistically significant(t=3.132,P<0.05).The scores of the field in movement and interaction,social activities and skills factor score and the total score of SSPI in the observation group were (15.49±3.54)points,(14.53±4.25)points,(39.25±8.27)points,respectively,which in the control group were (12.78±3.29)points,(10.01±3.78)points,(33.72±7.83)points,respectively,the differences between the two groups were statistically significant (t=3.317,4.701,2.873,all P<0.05).Conclusion Amisulpride is effective in improving the negative symptoms,social function in patients with schizophrenia,and the effect is better than risperidone.

Objective To investigate the role of the expression of latent transforming growth factor beta binding protein-1 (LTBP-1) and transforming growth factor beta receptor type Ⅱ(TGF-beta R Ⅱ) in the pathogenesis of condyloma acuminatum (CA). Methods Samples were resected from the lesions of 30 patients with CA and prepuces of 17 normal human controls. The mRNA and protein expressions of LTBP-1 and TGF-betaR Ⅱ were assessed by quantitative real-time PCR and a streptavidin-biotin-peroxidase staining technique, respectively. Results As shown by Real time PCR, the mRNA expression levels of LTBP-1 and TGF-betaR Ⅱ were significantly higher in CA tissues than those in the controls, with the average value of 2 (-Delta Delta α) being 2.46 and 3.43, respectively. A lower intensity of stainning was observed for LTBP-1 and TGF-betaR Ⅱ in CA tissues compared with the normal controls (182.51±9.89 vs 167.78±12.56, 187.35± 11.23 vs 170.15±13.21, t = 5.62, 3.70 respectively, both P <0.01). Conclusion The decrease in the expres-sion of both LTBP-1 and TGF-betaR Ⅱ may lead to the abnormality in the activation of TGF-beta and signal transduction pathways.

Objective To investigate the feasibility and effects of endoscopic surgical treatment of lumbar intervertebral disc herniation associated with veitebral osteochondrosis.Methods From June 2008 to December 2015,276 cases of lumbar intervertebral disc herniation associated with vertebral osteochondrosis were treated with endoscopic surgery,including 185 men and 91 women,with an average 39.2 years old (range,16-65 years old).The involved level included L2.3 in 2 cases,L3.4 in 9 cases,L4,5 in 126 cases and L5S1 in 139 cases.On preoperative axial CT,the diameter of ossification was more than half of the transverse or sagittal diameter of the spinal canal in 89 cases,and no more than half of the transverse and sagittal diameter of the spinal canal in 187 cases.All patients were operated on the side with serious symptom,181 cases were operated with mobile microendoscopic discectomy (MMED),and 95 cases were operated with percutaneous endoscopic surgery,including percutaneous transforaminal endoscopic discectomy (PTED) in 61 cases and the percutaneous interlaminar endoscopic discectomy (PIED) in 34 cases.The operation and complications were analyzed.Results The soft herniation,broken disc material and the periphery of compressing ossification were removed under the endoscope in all cases,until the nerve was well decompressed.However,the ossification was not complete resected.Dural sac tear occurred in 3 cases of MMED.In the early stage of PTED,2 cases converted to MMED because of intraoperative pain and difficulty,and one case had exiting nerve root injury.At the final follow-up of 12-60 months (average,20.6 months),visual analogue scale decreased from preoperative 8.5±1.2 to 1.0±0.9,Oswestry disability index decreased from preoperative 40.2±8.6 to 3.1±3.0.According to Macnab scale,the results were excellent in 89,good in 154 cases,moderate in 33 cases.Conclusion For most lumbar intervertebral disc herniation associated with vertebral osteochondrosis,good results can be achieve by removal of herniated and broken intervertebral disc and decompression of nerve with endoscope.Therefore,we speculate that the soft disc herniation and spinal stenosis are main pathogenic factors,and that the complete resection of ossification is not needed.

OBJECTIVE:To determinate the release rate and in vitro transdermal rate of asarinin in Cancer pain cataplasm. METHODS:Using homemade devices and modified France diffusion,isolated skin of rats as barrier,normal saline as solvent,the content of asarinin was determined by HPLC. Release rate of Cancer pain cataplasm within 20,50,80 and 120 min and transder-mal amount within 2,4,8,12,24 h were investigated,and accumulative release rate and accumulative transdermal rate were cal-culated. RESULTS:Accumulative release rate by 120 min of asarinin in Cancer pain cataplasm was 73.01%;24 h in vitro transder-mal rate was 26.01%,and transdermal kinetics equation of asarinin was Q=5.717 7t1/2-0.385 4(r=0.979). CONCLUSIONS:Cancer pain cataplasm has good release and transdermal performance. Its transdermal kinetics is in line with Higuchi equation.

Objective:To evaluate the value and efficacy of self-anchored anterior lumbar discectomy and fusion (SA-ALDF) for L 5 isthmic spondylolisthesis. Methods:From June 2018 to December 2019, a total of 11 cases of L 5 isthmic spondylolisthesis were treated with SA-ALDF, including 4 men and 7 women, aged 43.2±12.6 (range 29-63) years. All patients had intractable low back pain aggravating during standing activities and alleviating during rest, without lower extremity radicular symptoms. Imaging examination showed bilateral isthmus cleft of L 5 with spondylolisthesis of 1 degree in 10 cases and 2 degree in 1 case according to Meyerding grading system. Under general anesthesia and supine French position, transverse 6 cm incision was made. Then, the L 5S 1 intervertebral disc was exposed via extraperitoneal approach between the bifurcation of abdominal aorta and vena cava. The intervertebral disc was sufficiently removed. The intervertebral space was released and distracted followed by canal ventral decompression and sequential mold testing. Suitable self-anchoring cage filled with auto iliac cancellous bone was implanted to restore intervertebral height and lordosis as well as reduction of spondylolisthesis. Under fluoroscopic guidance, the distal anchoring plate was knocked into the sacrum followed by direct reduction and proximal anchoring plate locking in the L 5 vertebral body. The patients were followed up for 12.1±4.7 (range 6-18) months. The visual analogue score (VAS) and Oswestry dysfunction index (ODI) were evaluated. The reduction and fusion were evaluated on the X-ray films. Furthermore, the rate of spondylolisthesis, the height and the lordosis of intervertebral space were measured. Results:The operation was performed successfully in all the patients with operation duration 90±18 (range 70-120) min, intraoperative blood loss 30±16 (range 10-60) ml. No severe complication such as nerve and blood vessel injury occurred. All patients experienced alleviation of symptom during follow-up. X-rays confirmed that the spondylolisthesis and alignment were recovered obviously without obvious cage displacement. However, the loss of reduction was 63.2% for the grade 2 spondylolisthesis. At the final follow-up, VAS decreased from 6.1±2.1 to 0.9±0.5, ODI decreased from 43.6%±14.2% to 6.0%±3.4%. The spondylolisthesis recovered from 17.7%±10.3% to 8.0%±7.2% with reduction rate of 54.8%±21.6%. The interverbral height recovered from 6.4±2.1 mm to 9.8±3.9 mm and intervertebral lordosis recovered from 4.8°±2.9° to 9.6°±4.7°.Conclusion:SA-ALDF can provide satisfactory outcomes for selected L 5 isthmic spondylolisthesis of degree 1 without neurological compromise. However, its mechanical stability may be insufficient for isthmic spondylolisthesis of degree 2.